Compliance Inspection Compliance Inspection Compliance Inspection # CI-2022-3206, Submission # Submission-2022-3421, UID # 41473
Status: Compliance Inspection Accepted
 

System Status

System status on date: 06/28/2022 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
220322144000620120 INGERSOLL AVE N, CITY OF FOREST LAKE20120INGERSOLLAVENFOREST LAKECITY OF FOREST LAKE55025KORTSHAGEN UWE R & DAGMAR2001
Owner's representative:
Name:
Tom Trooien
Phone:
(651439 - 7323
Email:
tomtrooien@aol.com

Impact on Public Health

System discharges sewage to
the ground surface:
No System discharges sewage to
drain tile or surface waters:
No System causes sewage backup
into dwelling or establishment:
No
Verification method(s):
Searched for surface outlet
Searched for seeping in yard/backup into home
Excessive ponding in soil system/D-boxes
Homeowner testimony (See Comments/Explanation)

Tank Integrity

System consists of seepage pit,
cesspool, drywell, or leaching pit:
No
Sewage tank(s) leak below their
designed operating depth:
No
Verification method(s):
Examined construction records
Examined empty (pumped) tank(s)
Comments/Explanation:
The tanks were at normal operating level, then were pumped for the inspection. Lowered a camera into the empty tanks - bottoms, walls, covers, baffles, risers and maintenance hole covers appear ok. The high water alarm was functional at the time of inspection.

Other Compliance Conditions

Maintenance hole covers are damaged, cracked,
unsecured, or appear to be structurally unsound:
No
Other issues (electrical hazards, etc.) to
immediately and adversely impact public
health or safety:
No
System is non protective of groundwater for other
conditions as determined by the inspector:
No

Date of Install

Date of install known: Yes
Date of installation: 07/12/2001

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging? No
Drainfield has at least a three-foot vertical separation
distance from periodically saturated soil or bedrock.:
Yes
Drainfield meets the designed vertical separation
distance from periodically saturated soil or bedrock.:
Yes
Verification method(s):
Conducted soil observation(s) (Attach boring logs)
A. Bottom of distribution media: 101.3 Decimal Feet
B. Periodically saturated soil/bedrock: 98.1 Decimal Feet
C. System separation: 3.2 Decimal Feet
D. Required compliance separation: 3 Decimal Feet

Operating Permit and Nitrogen BMP

Is system operating under an Operating Permit: No
Is the system required to employ Nitrogen BMP: No

Comments and File Attachments

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
All State Septic ServicesL1568651-439-732312155 Norell Ave N Stillwater, MN 55082NoNoNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: tomtrooien@aol.com

Terms

Certification
  • By submitting this form I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No determination of the future
    system performance has been nor can be made due to unknown conditions during system construction, possible abuse of the system, inadequate
    maintenance, or future water usage

Invoice #8241 (06/28/2022)

Charge Cost Quantity Total
Non-Taxable
added 06/28/2022 5:58 PM

$47 Flat Fee

$44.00 x 1 $44.00
Grand Total
Total $44.00
Payment 06/28/2022$44.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantTom Trooien - 06/28/2022 5:58 PM
57a25f38266983db11f9c18814f6944d
1aeccbd5874c95c5dc8ccc67c97974c1
 
#1 Compliance Inspection AcceptedSarah Borrell - 07/27/2022 12:35 PM
cbff33e7d919eba7b9ed204ae03b8549
1e42d481e649d3cba8dc53d0d7ba6801
 
Inspection has been approved. All signatures have been obtained.
Text:
File(s):
    Text:
    File(s):
      Compliance Letter Type: Certificate of Compliance Who's signature should be on the letter? Sarah Borrell Permit number to reference in "No Replace" letter:
      Was the letter sent? Yes Compliant/Non-Compliant: Compliant
      Certificate of Compliance:
        Letter of Non-Compliance:
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